万古霉素联合丙种球蛋白治疗新生儿败血症的疗效及对血小板及胆红素的影响研究
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摘要
探讨万古霉素联合丙种球蛋白治疗新生儿败血症的临床疗效及对血小板以及胆红素的影响。选取该院2017年1月至2019年1月收治的符合入选标准的新生儿败血症患儿84例为观察对象,数字法随机将其分为对照组(n=42例)与试验组(n=42例),两组均给予患者维持水电解质平衡等常规治疗,对照组在其前提下给予患者利奈唑胺治疗,试验组则在常规基础上给予患者万古霉素联合丙种球蛋白治疗。观察比较两组患者拒奶、神经系统等症状指标、住院时间、临床疗效、免疫学指标血清免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)、自然杀伤细胞(NK细胞)活性,同时比较两组患者的总胆红素以及血小板计数,并观察两组不良反应情况。试验组患者症状改善以及住院时间均短于对照组(P <0. 05);试验组患者的临床治疗总有效率为92. 86%,高于对照组的73. 81%(P <0. 05);试验组患者的Ig G、NK细胞高于对照组,而Ig M明显低于对照组(P <0. 05);试验组患者的总胆红素低于对照组,而血小板计数高于对照组(P <0. 05);两组不良反应发生率比较差异无统计学意义(P> 0. 05)。万古霉素联合丙种球蛋白可以明显改善新生儿败血症患儿临床症状,缩短住院时间,提高疗效,并可调节机体免疫水平,稳定血小板及总胆红素,具良好临床应用价值。
To investigate the clinical effect of vancomycin combined with gamma globulin in the treatment of neonatal sepsis and its effect on platelets and bilirubin,84 neonatal sepsis patients admitted to the author's hospital from January 2017 to January 2019 who met the inclusion criteria were selected as the observation objects; they were randomly divided into control group( n = 42 patients)and experimental group( n = 42 patients) by numerical method; both groups were given routine treatment such as maintaining water and electrolyte balance,the control group was treated with linidazolamide,while the experimental group was treated with vancomycin combined with gamma globulin on a routine basis. The author compared two groups of patients from milk,neurological symptoms such as index,the length of time,clinical curative effect and immunological indexes of serum immunoglobulin G( Ig G),immunoglobulin M( Ig M),natural killer cells( NK cells) activity; at the same time compared two groups of patients in total bilirubin and platelet count,and observed two groups in adverse reactions. The improvement of symptoms and length of stay in the experimental group were shorter than those in the control group( P < 0. 05). The total clinical effective rate of the experimental group was 92. 86%,higher than 73. 81% of the control group( P < 0. 05). Ig G and NK cells in the experimental group were higher than those in the control group,while Ig M was significantly lower than that in the control group( P < 0. 05). The total bilirubin in the experimental group was lower than that in the control group,while the platelet count was higher than that in the control group( P < 0. 05). There was no statistically significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Vancomycin combined with gamma globulin can significantly improve the clinical symptoms of neonatal sepsis,shorten the length of hospital stay,improve the efficacy,regulate the immune level of the body,stabilize platelets and total bilirubin. So it is worthy of promotion and application.
To investigate the clinical effect of vancomycin combined with gamma globulin in the treatment of neonatal sepsis and its effect on platelets and bilirubin,84 neonatal sepsis patients admitted to the author's hospital from January 2017 to January 2019 who met the inclusion criteria were selected as the observation objects; they were randomly divided into control group( n = 42 patients)and experimental group( n = 42 patients) by numerical method; both groups were given routine treatment such as maintaining water and electrolyte balance,the control group was treated with linidazolamide,while the experimental group was treated with vancomycin combined with gamma globulin on a routine basis. The author compared two groups of patients from milk,neurological symptoms such as index,the length of time,clinical curative effect and immunological indexes of serum immunoglobulin G( Ig G),immunoglobulin M( Ig M),natural killer cells( NK cells) activity; at the same time compared two groups of patients in total bilirubin and platelet count,and observed two groups in adverse reactions. The improvement of symptoms and length of stay in the experimental group were shorter than those in the control group( P < 0. 05). The total clinical effective rate of the experimental group was 92. 86%,higher than 73. 81% of the control group( P < 0. 05). Ig G and NK cells in the experimental group were higher than those in the control group,while Ig M was significantly lower than that in the control group( P < 0. 05). The total bilirubin in the experimental group was lower than that in the control group,while the platelet count was higher than that in the control group( P < 0. 05). There was no statistically significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Vancomycin combined with gamma globulin can significantly improve the clinical symptoms of neonatal sepsis,shorten the length of hospital stay,improve the efficacy,regulate the immune level of the body,stabilize platelets and total bilirubin. So it is worthy of promotion and application.
引文
[1]贾忠兰,毕福玲,张彩明.新生儿败血症病原菌分布及耐药性分析[J].中华医院感染学杂志,2017,27(1):197-200.
[2]张慧芬,李基明,谢辉,等.新生儿败血症的菌株及耐药性分析[J].中国生育健康杂志,2016,27(3):256-258.
[3]崔雪薇.新生儿败血症临床检测指标的研究进展[J].国际儿科学杂志,2015,42(2):177-180.
[4]韩晋丽,张小莉,王艳芬,等.早产儿及足月儿新生儿败血症临床特征比较分析[J].中国妇幼保健,2016,31(6):1199-1201.
[5]中华医学会儿科学分会新生儿学组,中华医学会《中华儿科杂志》编辑委员会.新生儿败血症诊疗方案[J].中华儿科杂志,2003,41(12):897-899.
[6]陈国庆.头孢噻肟联合丙种球蛋白治疗新生儿败血症的疗效及对C反应蛋白、降钙素原和CD64的影响[J].儿科药学杂志,2015,21(6):21-23.
[7]潘新年,李燕,韦秋芬,等.不同胎龄早产儿免疫功能水平及影响因素[J].中国新生儿科杂志,2015,30(6):428-432.
[8]张立梅.儿童反复肺炎与机体免疫功能和炎性相关因子的关系研究[J].河北医药,2016,38(9):1333-1335.
[9]李晶,巴依尔才次克,李明霞.万古霉素治疗新生儿MRSA败血症对患儿炎症指标的影响及临床效果[J].国际检验医学杂志,2018,39(11):1318-1321.
[10]Butin M,Martinssimdes P,Picaud JC,et al.Adaptation to vancomycin pressure of multiresistant Staphylococcus capitis NRCS-Ainvolved in neonatal sepsis[J].J Antimicrob Chemother,2015,70(11):3027-3031.
[11]高雪花,曹雯,李培杰,等.万古霉素血药谷浓度监测在ICU患者中的应用[J].中国急救医学,2016,36(6):528-532.
[12]文丹.丙种球蛋白在改善复发性流产患者免疫状态中的应用及其安全性分析[J].药物生物技术,2018,25(1):43-46.
[13]赵波,杜雪梅.头孢噻肟联合丙种球蛋白治疗新生儿败血症的疗效评价[J].中国生化药物杂志,2017,37(9):284-285.
[14]陈兴月.万古霉素对新生儿败血症患儿的临床预后及免疫功能的影响[J].中国临床药理学杂志,2015,31(22):2184-2186.
[15]刘玉秀.新生儿败血症应用头孢噻肟联合丙种球蛋白治疗效果观察[J].中国药物与临床,2017,17(4):565-567.
[16]张丽娇.静脉滴注丙种球蛋白辅助治疗新生儿败血症疗效及外周血清炎性因子影响[J].中国儿童保健杂志,2016,24(11):1222-1224.
[17]孙捷.早期与晚期早产儿合并早发型败血症时的免疫功能特征比较[J].新乡医学院学报,2017,34(6):542-544.
[18]唐莲,王三南,翁小红,等.利奈唑胺治疗新生儿败血症的疗效及对血小板的影响[J].药物不良反应杂志,2016,18(2):99-104.
[2]张慧芬,李基明,谢辉,等.新生儿败血症的菌株及耐药性分析[J].中国生育健康杂志,2016,27(3):256-258.
[3]崔雪薇.新生儿败血症临床检测指标的研究进展[J].国际儿科学杂志,2015,42(2):177-180.
[4]韩晋丽,张小莉,王艳芬,等.早产儿及足月儿新生儿败血症临床特征比较分析[J].中国妇幼保健,2016,31(6):1199-1201.
[5]中华医学会儿科学分会新生儿学组,中华医学会《中华儿科杂志》编辑委员会.新生儿败血症诊疗方案[J].中华儿科杂志,2003,41(12):897-899.
[6]陈国庆.头孢噻肟联合丙种球蛋白治疗新生儿败血症的疗效及对C反应蛋白、降钙素原和CD64的影响[J].儿科药学杂志,2015,21(6):21-23.
[7]潘新年,李燕,韦秋芬,等.不同胎龄早产儿免疫功能水平及影响因素[J].中国新生儿科杂志,2015,30(6):428-432.
[8]张立梅.儿童反复肺炎与机体免疫功能和炎性相关因子的关系研究[J].河北医药,2016,38(9):1333-1335.
[9]李晶,巴依尔才次克,李明霞.万古霉素治疗新生儿MRSA败血症对患儿炎症指标的影响及临床效果[J].国际检验医学杂志,2018,39(11):1318-1321.
[10]Butin M,Martinssimdes P,Picaud JC,et al.Adaptation to vancomycin pressure of multiresistant Staphylococcus capitis NRCS-Ainvolved in neonatal sepsis[J].J Antimicrob Chemother,2015,70(11):3027-3031.
[11]高雪花,曹雯,李培杰,等.万古霉素血药谷浓度监测在ICU患者中的应用[J].中国急救医学,2016,36(6):528-532.
[12]文丹.丙种球蛋白在改善复发性流产患者免疫状态中的应用及其安全性分析[J].药物生物技术,2018,25(1):43-46.
[13]赵波,杜雪梅.头孢噻肟联合丙种球蛋白治疗新生儿败血症的疗效评价[J].中国生化药物杂志,2017,37(9):284-285.
[14]陈兴月.万古霉素对新生儿败血症患儿的临床预后及免疫功能的影响[J].中国临床药理学杂志,2015,31(22):2184-2186.
[15]刘玉秀.新生儿败血症应用头孢噻肟联合丙种球蛋白治疗效果观察[J].中国药物与临床,2017,17(4):565-567.
[16]张丽娇.静脉滴注丙种球蛋白辅助治疗新生儿败血症疗效及外周血清炎性因子影响[J].中国儿童保健杂志,2016,24(11):1222-1224.
[17]孙捷.早期与晚期早产儿合并早发型败血症时的免疫功能特征比较[J].新乡医学院学报,2017,34(6):542-544.
[18]唐莲,王三南,翁小红,等.利奈唑胺治疗新生儿败血症的疗效及对血小板的影响[J].药物不良反应杂志,2016,18(2):99-104.